Pharmacist · English Edition
I look after the English edition.
After graduating from the faculty of pharmaceutical sciences at a national university, she worked at a major dispensing pharmacy chain in Japan. She has reviewed beauty products on social media since her student days and is good at explaining complex ingredients in plain words. She is bilingual in Japanese and English. At Japan Medical Press she writes and reviews articles on medicines and beauty, looks after the English edition, and handles our work with medical institutions.
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- Directions
- 用法・用量 = frequency (1日3回, three times a day), timing (食後, after meals) and amount (1回1錠, one tablet). 頓服 means only when needed.
- OTC class
- Printed on every box: 要指導, 第1類, 指定第2類, 第2類, 第3類. Pharmacist-guided and Class 1 products need a pharmacist's explanation.
- Side effects
- Call the pharmacy named on the bag or the prescribing clinic right away, and ask before you stop a prescribed medicine. Call 119 for difficulty breathing or facial swelling.
What you receive at the pharmacy
When a Japanese pharmacy fills a prescription, the medicines come in a paper bag called a yakutai (薬袋). It shows your name, the pharmacy's name and phone number, the dispensing date, and the directions for taking each medicine. Most pharmacies also hand you a sheet called a yakuzai jōhō teikyōsho (薬剤情報提供書), which lists every drug with its name, a photo or drawing of the tablet, what it is for, and its main precautions. Keep both; they are the fastest way for another pharmacist or doctor to see what you have been given. If you have not yet visited a pharmacy, read how to use a Japanese pharmacy first.
The words on the bag
Directions are printed under the heading 用法・用量 (yōhō yōryō), "how and how much." The pattern is usually a frequency, a timing and an amount. These are the phrases you will see most often:
- 1日1回 / 1日2回 / 1日3回 (ichinichi ikkai / nikai / sankai) — once, twice or three times a day.
- 1回1錠 (ikkai ichijō) — one tablet per dose. 錠 is a tablet, カプセル a capsule, 包 a sachet of powder; liquids are given in mL.
- 食前 (shokuzen) — before meals; 食後 (shokugo) — after meals; 食間 (shokkan) — between meals, roughly two hours after eating, not during the meal.
- 毎食後 (maishokugo) — after every meal; 朝食後 (chōshokugo) — after breakfast; 夕食後 (yūshokugo) — after dinner.
- 起床時 (kishōji) — on waking; 就寝前 (shūshinmae) — at bedtime.
- 頓服 (tonpuku) — take only when needed, for example for pain or fever. The bag states the minimum interval between doses and the daily maximum.
- 外用 (gaiyō) — external use only: ointments, patches, eye or nose drops.
Do not change the amount or timing yourself. If anything on the bag is unclear, ask before you leave: the pharmacist is required to explain the medicines to you.
The medicine notebook (お薬手帳)
An okusuri techō (お薬手帳) is a small booklet in which each pharmacy sticks a label recording what it dispensed. It lets any pharmacy or hospital in Japan see your history at a glance and check for duplicated or interacting medicines. You can ask for one free of charge at the counter. There are smartphone versions too. The Ministry of Health, Labour and Welfare issues a guideline for electronic medicine notebook apps and publishes a list of services that follow it, and apps linked to the Myna Portal can pull in, with your consent, the records of medicines you were given at medical institutions and pharmacies; where the pharmacy handles electronic prescriptions, the information appears in real time. [2]
OTC boxes: the risk class
Every non-prescription medicine sold in Japan carries a class printed on the front of the box near the product name. It tells you how the product may be sold. [1]
- 要指導医薬品 (yōshidō iyakuhin) — pharmacist-guided drugs, often products recently switched from prescription status. A pharmacist must explain them to you face to face, and they are not sold online.
- 第1類医薬品 (daiichirui) — Class 1. Sold only by a pharmacist, who gives you written information first.
- 指定第2類医薬品 (shitei dainirui) — Designated Class 2, a subset of Class 2 that calls for extra attention. Displayed near the counter with a notice to read the leaflet.
- 第2類医薬品 (dainirui) — Class 2: most cold, pain and allergy remedies. It can be sold by a registered seller as well as by a pharmacist.
- 第3類医薬品 (daisanrui) — Class 3: the lowest-risk group, such as vitamins and some digestive aids.
The number is sometimes printed as a circled numeral such as ②; the higher it is, the fewer the restrictions.
Where do you find the active ingredient?
The side or back of an OTC box has a table headed 成分 (seibun, ingredients) or 成分・分量 (seibun bunryō, ingredients and amounts), usually stated per daily dose or per tablet. Active ingredients are written in katakana using their international names, for example アセトアミノフェン for acetaminophen or ロキソプロフェン for loxoprofen, and the same names appear on the line marked 有効成分 (yūkō seibun). Photograph the katakana or type it into a translation app, then look the name up in our medicine guide to see what the ingredient is and which countries restrict it. Combination cold medicines often contain several ingredients, so read the whole table and check for overlap with anything else you take.
The leaflet: "do not" and "consult"
Inside every OTC box is a folded leaflet, the tenpu bunsho (添付文書). Two boxed sections near the top matter most. 「してはいけないこと」 (shite wa ikenai koto, "things you must not do") lists absolute rules, such as not using the product if it has ever caused you an allergic reaction, not combining it with other products containing the same ingredients, or not driving after taking it. 「相談すること」 (sōdan suru koto, "things to consult about") lists situations in which you should ask a pharmacist or doctor before use, for example pregnancy, breastfeeding, certain medical conditions or being under a stated age. The Pharmaceuticals and Medical Devices Agency (PMDA) keeps a searchable database of the leaflets for OTC and pharmacist-guided products, so you can read the leaflet on your phone before you buy. [3]
English package inserts and their limits
PMDA hosts English translations of package inserts, but they are prepared by the manufacturers, cover only a selection of prescription products, and are marked as reference material. The Japanese text is the official document, and a translation may lag behind revisions. [4] There is no official English database of OTC leaflets. In practice, the most reliable approach is to read the ingredient table and ask a pharmacist.
"Generic" on the label
Prescription labels often say 後発品 (kōhatsuhin) or ジェネリック, meaning a generic. Generics in Japan are approved as therapeutically equivalent to the original brand and carry a lower price, and they now account for almost 90% of the volume wherever a generic exists. [5] If you ask for a brand-name product that has a generic without a medical reason, you pay a special charge on top of your co-payment; since June 2026 it has been equivalent to half the price difference. [8] You may also see 【般】 before a drug name on your prescription or bag. It marks 一般名処方 (ippanmei shohō), a prescription written by generic name rather than brand, which lets the pharmacist choose any product with that active ingredient.
Expiration dates and storage
OTC boxes show 使用期限 (shiyō kigen), the expiration date, usually as year and month on the bottom or side of the box. Prescription tablets are cut from larger sheets and may show no date. Ask the pharmacist how long they keep, and use the dispensing date on the bag as your reference. Storage instructions appear as 室温保存 (shitsuon hozon, room temperature), 冷所保存 (reisho hozon, keep cool, usually the refrigerator), 遮光 (shakō, keep out of light) and 湿気を避ける (avoid humidity). Dates on Japanese documents sometimes use the era year: 令和8年 is 2026.
What should you do if you get a rash or feel unwell?
Call the pharmacy whose number is on the bag, or the clinic that prescribed it, right away. Either can tell you whether to stop, continue or switch. Do not stop a prescribed medicine on your own, because stopping some medicines suddenly can make the illness worse. [7] If the product is an over-the-counter medicine, stop using it and see a doctor or ask a pharmacist. For severe symptoms such as difficulty breathing, swelling of the face or throat, or a widespread rash with fever, call 119 for an ambulance. Whenever you see a doctor about the reaction, bring the medicine you think caused it. Japan also runs a public relief system for people harmed by properly used medicines, prescribed or purchased, which pays benefits when the damage is serious enough to need hospital treatment. PMDA handles the claims. [6] Keep the box, leaflet and bag, since they identify the product if a reaction has to be reported. To find an English-speaking doctor, use our hospital search.
Glossary
- 薬局 (yakkyoku) — dispensing pharmacy
- 処方箋 (shohōsen) — prescription
- 薬袋 (yakutai) — medicine bag
- 薬剤情報提供書 (yakuzai jōhō teikyōsho) — drug information sheet
- お薬手帳 (okusuri techō) — medicine notebook
- 用法・用量 (yōhō yōryō) — directions and amount
- 成分 (seibun) — ingredients; 有効成分 (yūkō seibun) — active ingredient
- 添付文書 (tenpu bunsho) — package insert
- 副作用 (fukusayō) — side effect
- 使用期限 (shiyō kigen) — expiration date
- 後発品 (kōhatsuhin) — generic
- 市販薬 (shihan'yaku) / 一般用医薬品 (ippan'yō iyakuhin) — over-the-counter medicine
Frequently asked questions (FAQ)
Can I get my prescription label in English?
Some pharmacies can print the bag or the information sheet in English on request, but it is not guaranteed. Ask the pharmacist to write the timing in English or in numbers on the bag, and photograph the drug information sheet.
What does 食間 (shokkan) mean?
Between meals, roughly two hours after eating, not with food. It is easy to confuse with 食後 (after meals), so check with the pharmacist if the bag says 食間.
Do I need a medicine notebook as a visitor?
No. It is useful if you are treated more than once in Japan, but a photo of each label, or a list of your regular medicines written with generic names, serves the same purpose.
Is a generic (後発品) the same medicine?
It contains the same active ingredient and is approved as therapeutically equivalent to the original brand. If you have a reason to want the brand-name product, tell the pharmacist when you hand in the prescription; under public insurance, choosing a brand-name drug that has a generic without a medical need adds a special charge to your bill.
Sources
- Ministry of Health, Labour and Welfare — Sales system for pharmaceuticals (classes of OTC and pharmacist-guided drugs) mhlw.go.jp
- Ministry of Health, Labour and Welfare — Electronic medicine notebook (お薬手帳) guideline and list of compliant services mhlw.go.jp
- Pharmaceuticals and Medical Devices Agency — Package insert search for OTC and pharmacist-guided drugs (Japanese) pmda.go.jp
- Pharmaceuticals and Medical Devices Agency — English-translated package inserts pmda.go.jp
- Ministry of Health, Labour and Welfare — Promotion of generic drugs (後発医薬品) mhlw.go.jp
- Pharmaceuticals and Medical Devices Agency — Outline of relief services for adverse health effects pmda.go.jp
- Government of Japan Public Relations Office — If you think a medicine is causing a side effect, consult a doctor at once (Japanese) gov-online.go.jp
- Ministry of Health, Labour and Welfare — Selective-care charge for brand-name drugs that have generics (長期収載品の選定療養) (Japanese) mhlw.go.jp
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This article is for general information only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified physician.
